Opioid use reduced in ER with dry needles, laughing gas

The ER at St. Joseph’s University Medical Center has decreased opioid prescriptions by 58 percent through their alternative program


By EMS1 Staff

PATERSON, N.J. — Doctors are working to reduce the use of opioids in one of the busiest ERs in the United States with an alternative program that utilizes laughing gas, dry needles and more.

NPR reported that the emergency room at St. Joseph’s University Medical Center has decreased opioid prescriptions by 58 percent through the Alternatives to Opiates program, according to Dr. Mark Rosenberg.

 "There is a complete change in philosophy, a complete change in culture in the department,” Rosenberg said.

Doctors are using dry needling of a trigger point to reduce pain for conditions such as muscle spasms, laughing gas to soothe patients and ultrasounds to locate nerves to inject numbing agents.

The ER even has a harpist that roams the halls to provide comfort for patients, who often are instructed to decrease their pain at home with ibuprofen, acetaminophen or a warm compress.

"We have to go back to times when things were a little more simple," Dr. Alexis LaPietra said. "Those easy, at-home techniques — good patient education, really — they help a lot with some of that pain that patients have to deal with when they go home."

Doctors in the ER said the program may seem simple, but it was a hard transition in the beginning.

"It took a little bit of getting used to," attending physician Dr. Ninad Shroff said. "I've been doing this for about 20 years, so for me, it was a big change."

Shroff said he still finds it “unbelievable” that he sometimes goes through entire ER shifts without prescribing a single opioid.

Rosenberg said nearby ER doctors have noticed changes because of the program and have asked, "Why are all the drug users from your area coming to my emergency department?"

"It's because they're not going to get opioids at our emergency department unless they're absolutely needed," Rosenberg said.

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